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If my kidneys have not gotten back from their extended vacation by Tuesday (Ive had low kindey function for about 6 months due to Truvada doc says), what are the other regimens she might switch me too?

Also, feel free to comment on the possible side effects of such regimens. So I can be prepared to shoot down any unfriendly regimens.

I'm in the same situation right now.My CREATININE has gone from .9 TO 1.67 in about a 7 month period so my doc is thinking of switching me to Epzicom if it doesn't come down soon.So your doc will probably give you the HLA B5701 test to make sure you can take Epzicom.

Are you going to get an update on that lump on your neck. I have been thinking about you and checking the forum regularly to see if you have learned anything else. If nothing else, I am very good at worrying.... :-)

Epzicom is the simplest. You need to do the allergy test, and a heart health risk assessment before deciding (not recommended in UK for people with more than 10% risk of developing heart disease over 10 years). Unfortunately people with poor kidney health have a worse heart health profile. Hobson's choice then....

Alternatively, there is an established dose adjustment for tenofovir, the drug in Truvada which affects the kidneys but 1) it means splitting Truvada into tenofovir and FTC, which means more co-pays (as I believe you US people have) 2) remembering to take a drug, say, every other day is a pain.

AZT/3TC (Combivir) is a virologically but perhaps not body fat friendly option.

There are many non-nuke combos you can use. Depends on your treatment history. Some may mean 1 or more drugs twice a day. Will that work, the 2 x day thing? Happy to go through them if you like (but need treatment history).

the manufacturer and some researchers claim that studies reporting an additional risk are biased because of a channeling effect.(also mentioned in the above article)

In my humble understanding, a channelling effect is when patients who have a condition X are preferably put on drug A rather than B. And if an additional risk is observed (between A and B) , it is attributed (falsely) to drug A instead of being attributed to condition X

if WillyWump is offered Epzicom, it would be a good example for being assigned to a drug (rather than an other) because of a preexisting condition.

Since the issue is still controversial (although FDA published a paper assigning no additional risk) it is still a (properly, IMHO) conservative approach to screen out patients who otherwise have an additional risk, if they have a choice between options (of course)...

For those who do not have a choice or are assigned to ABC, it is comforting to know that the latest work on ABC's suspected additional risk are more in favor of the no-additional risk opinion.It has become a first choice (preferred) drug in some areas, too...

As an Epzicom user, I suspect that it gives me additional stress, but I am otherwise confident/comfortable with it.

The HLA B5701 test and selector is very efficient (before the test was enforced, the incidence of hypersensitivity reaction was in the 5 to 6 % , on top of my mind, and is now below 1 %)

With all the options on the table, I am quite hopeful that you will find a solution to this kidney issue...

Are you going to get an update on that lump on your neck. I have been thinking about you and checking the forum regularly to see if you have learned anything else. If nothing else, I am very good at worrying.... :-)

Gary

Well Garykins you're good at alot of things. Yes, I'll get the thyroid test results and the throat cultures results on Tuesday as well. Not much has changed there. Still have the weird sensation that I'm being choked. Also am enduring another round of my "intermittent fevers" right now (only 99.6 though). Good news is my saliva came back, so my mouth is good and wet once again. I will post an update when I get the good news (hopefully) that its just some throat infection or whatever .

@Newt and the others - Ok, Epzicom, I'll keep that in mind and do some research on it in the meantime. However I will say that I dont like the Idea of switching Kidney problems for potential heart problems, albeit slight.

If I switched to Epzicom, would I still stay on the Prezista and Norvir?

I wouldn't mind doing the Truvada dose adjustment, would ahve no problem with taking something every other day.

Newt, no way am I going to pass up a "Newt Review and Assesment"...

Treatment history is as follows (to the best of my memory). Was originally on Atripla for approx 6 months (viral load dropped from 180k to 100 copies during that time) then had a Viral load increase to 1500. Doc switched me to my current regimen of Prez/Tru/Norvir. Immediately went undectable and have stayed that way, CD4's have gone from 200 to 840 during the 2 years I have been on P/T/N. Only recently, within the past 6 months have my GFR rates gone to 70ish.

Not real happy about the switch at all. But it is what it is. Doc went over all the ABC Heart attack issues and repeated the fact that studies are contradicting each other but are starting to show no significant risk (as we've talked about here). Which I guess is great unless I happen to be the one that goes "tits up" from a Heart Attack.

I asked her about other options...said something about saving the Non-Nukes for down the road if need be, and wouldnt consider an adjsuted Tenofir dose (due to GFR level). Basically she said in her professional opinion Epzicom would be best for me right now. SO be it.

Regarding The Throat issue, all swabs came back normal as did the Thyroid tests. While this seems like good news, It's really not as it means that there is still something going on. She is scheduling me to get scoped, hopefully next week. In the meantime she is starting me on Nexium to see if it is just esophogeal spasms.

Regarding the intermittent unexplained fevers, she is putting me on a round of Levaquin to "see what happens".

So to round out this Bad News Fest.....I lost 230 Tcells. My CD4's are 617 down from 842. NOT HAPPY! Doc attributed it to the fevers and the fact that my body is fighting something.

In other news...My Testosterone is FINALLY NORMAL (ok, low normal) @ 238. However this may be due to the fact I shot up the night before labs.

Oh and I gained 4 pounds up to 160 now. All Pure muscle gain I'm sure Although I have been hitting the cakes pretty hard.

Me too, but my doctor is reluctant to change my Truvada, but tells me every-time that it is most likely the culprit, the renal doctor doesn't have a clue why, he cannot seem to connect the dots about my 20ys.HIV/AIDS Drug history and the correlation to the Truavda, I find this very troubling from both my Doctors, as to why I'm still on Truavda after 4 yrs. my current GRF is 51, and my creatinine is H 1.50

« Last Edit: March 29, 2011, 02:13:41 PM by denb45 »

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"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Me too, but my doctor is reluctant to change my Truvada, but tells me every-time that it is most likely the culprit, the renal doctor doesn't have a clue why, he cannot seem to connect the dots about my 20ys.HIV/AIDS Drug history and the correlation to the Truavda, I find this very troubling from both my Doctors, as to why I'm still on Truavda after 4 yrs. my current GRF is 51, and my creatinine is H 1.50

Yikes, I think my doc would have pased out If my GFR was 51, I dont know maybe she is too cautious. It seems if you have done ok at 51 for all these years I could go on at 61 for awhile???

160 lbs? You're like a bird honey. Doesn't matter how much you go to the gym if you sit in the steam room, then follow it up with drive-through fried chicken and eat a quarter of an entire cake. Something isn't adding up here.

The odd thing is over the past month my appetite has been voracious, moreso than ever. I used to just eat to survive, but now I am eating literally everything in sight. frankly I'm surprised Im only at 160.

Willy hope everything turns out ok..how long were u on truvada...I'm freaking out..sorry I'm a newbie and just don't want to change medication...does this happen to everyone? All the best

Not everyone develops this side effect from Truvada but it's a known issue of the drug. If I remember correctly Willy was on Truvada for three years, but you see how seamlessly he changed to another option.

I still am scared and I guess noone can predict the future but is the kidney damage reversible? I just worry about what if that happens an then u can't take epzicom bc of the blood test an allergic reaction...I knownit senseless but how long have people on Atripla or truvada successfully without changing..

I still am scared and I guess noone can predict the future but is the kidney damage reversible? I just worry about what if that happens an then u can't take epzicom bc of the blood test an allergic reaction...I knownit senseless but how long have people on Atripla or truvada successfully without changing..

Are your current meds working? If so, worrying about what might happen really isn't worth it. Cross that bridge when the time comes.

« Last Edit: March 29, 2011, 03:55:37 PM by woodshere »

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"Let us give pubicity to HV/AIDS and not hide it..." "One of the things destroying people with AIDS is the stigma we attach to it." Nelson Mandela

Yes Meds r working! Dont want to stop them unless of course a cure lol... And i guess truvada must not be toxic all the time since thats the drug used for PreP...has to be somehat safe..Next week 5 months dx and just so scared...this place has been a great help but sometimes reading this scares me more even though it isbgreat support and I know everyone experience difference...so just breathe right!

The odd thing is over the past month my appetite has been voracious, moreso than ever. I used to just eat to survive, but now I am eating literally everything in sight. frankly I'm surprised Im only at 160.

Oh dear, are u sure ur not substituting Food over Sex, have more Sex, if ur gonna get eat like that @ least that way you'll burn-off all of those calories form all that food, or maybe not

« Last Edit: March 29, 2011, 04:36:18 PM by denb45 »

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"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Not everyone develops this side effect from Truvada but it's a known issue of the drug. If I remember correctly Willy was on Truvada for three years, but you see how seamlessly he changed to another option.

Trey, my renal problems started about 10 yr ago, before Truvada even came out, so, for me, it's more than 20 yrs. of other Meds that may have caused this

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"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Not everyone develops this side effect from Truvada but it's a known issue of the drug. If I remember correctly Willy was on Truvada for three years, but you see how seamlessly he changed to another option.

Hey PPP, Jsut want to reiterate what Hellraiser said, I am of a very small minority who experience Kidney problems with Truvada. Your doc will be testing you often to keep an eye on your Kidney (I think its standard testing for Truvada). The kidney impairment is 100 reversible, at least until you get into severe impariment which your doc will not let happen. Also It doesnt happen suddenly, it creeps up slowly.

Dont worry.

But I might add, increasing your water intake will help your kidneys remove Truvada, water is a good thing with Truvada

Willy....YES should be drinking @ least 8 to 10 glasses of water a day, I even put real lemon juice in my water, it actually stopped my kidney stones form recurring, you have to FLUSH your kidneys out of all the toxins, so push them fluids as much as you can willy

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"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Yikes, I think my doc would have pased out If my GFR was 51, I dont know maybe she is too cautious. It seems if you have done ok at 51 for all these years I could go on at 61 for awhile???

Just got back from my doc.My creatinine is actually down from 1.67 to 1.5 so we are holding off switching to epzicom.He says he probably won't switch unless my GFR gets below 45 or so.My Doc considers anything above 60 GFR normal.

Willy thanks for the reply...everyone here is so nice...it's truly amazing...I drink tons of water and add lemon juice too...sometimes I'll out a cap full of apple cider vinegar cause I hear it's good for the kidneys especially since I have have two episodes of stones..but I'm worried too much water will eliminate the truvada and the virus will become resistant...my mom says I'll find something to worry about no matter what...but u guys really do make someone feel at home here even when I never wanted to visit this home in the first place...I know, nobody does...what's everyone doing for dinner lol (try to take my mind off this stuff)

Well that kinda pisses me off, that both your docs are fine with GFR's of 51 and 45, and yet mine is forcing a regimin change at 60 You know, this is the same doc that yanked me off Atripla for what may have been a VL blip.

Well that kinda pisses me off, that both your docs are fine with GFR's of 51 and 45, and yet mine is forcing a regimin change at 60 You know, this is the same doc that yanked me off Atripla for what may have been a VL blip.

I wanted to bring up Truvada and kidney health and was wondering what everyones thoughts on taking vitamin D and calcium because it could also effect renal health in a negative way...thoughts? Scared of truvada to begin with and now even more scared bc I take vitamin D...how come we don't have a better backbone than Truvada?

i've been having joint pains lately and had dr appt today, he advised me that the Viread in Atripla can have effects on Vitamin D levels, but usually with folks that have been taking it for a long while . In the myriad of all the other tests for testosterone, RA factor he also is having my Vitamin D levels checked just to satify me i suppose.